Inflammatory Modifications in Paranasal Sinuses and Ostiomeatal Complex Anatomical Variations in Jet Aircraft Pilots: A Computed Tomography Study

Abstract Introduction Jet aircraft pilots are exposed to huge pressure variation during flight, which affect physiological functions as systems, such as the respiratory system. Objectives The objective of the present investigation was to evaluate inflammatory changes of paranasal sinuses of jet aircraft pilots before and after a jet aircraft training program, using multislice computed tomography (CT), in comparison with a group of nonairborne individuals with the same age, sex, and physical health conditions. A second objective of the present study was to assess the association between the ostiomeatal complex obstruction and its anatomical variations. Methods The study group consisted of 15 jet aircraft pilots participating in the training program. The control group consisted of 41 nonairborne young adults. The 15 fighter pilots were evaluated before initiating the training program and after their final approval for the presence of inflammatory paranasal sinus disease. The ostiomeatal complex anatomical variations and obstructions were analyzed in pilots after the training program. Results Jet aircraft pilots presented higher incidence of mucosal thickening in maxillary sinus and anterior ethmoid cells than controls. Prominent ethmoidal bulla showed significant association with obstruction of the osteomeatal complex. Conclusions Jet aircraft pilots present increased inflammatory disease when compared with nonairborne individuals. The presence of a prominent ethmoidal bulla is associated with ostiomeatal complex obstruction.

Screening for Distress and Its Impact on Palliative Care Referral at a General Medical Center: Retrospective Cohort Study

Purpose: Distress screening is mandated by Ministry of Health, Labor and Welfare of Japan, however there is few data available on its effect in actual practice. We examined the impact of distress screening on palliative care referral at Hyogo Prefectural Amagasaki General Medical Center in Japan. Materials and Methods: We implemented distress screening on cancer patients who were given chemotherapy from February 2018. Patients were referred to the palliative care team when the physicians judged the need on the basis of the screening results or when the patients themselves wanted to receive the palliative care service. We examined the number of the patients referred to the palliative care team, then we researched the changes of the number after implementation of the screening, using the regression discontinuity analysis. Results: The distress screening didn’t increase the number of the patients who were referred to the palliative care team: the estimated difference of the number was 3.32 (95% confidence interval: −3.19〜9.82). Conclusion: We implemented distress screening at our hospital but it didn’t increase palliative care referral. Only a few studies have examined how routine screening impacts clinical outcomes. We expect our study helps to research the effectiveness of screening in each healthcare facility.

Do HIV patients have mandibular osteoporotic alterations? A mandibular cortical index case-control study / Pacientes com infecção por HIV tem alterações osteoporóticas na mandíbula? Um estudo caso controle utilizando o índice da cortical mandibular

Objective: The objective of this study was to evaluate mandibular osteoporotic alterations in patients with HIV infection in comparison to non-HIV-infected patients using panoramic radiographs. Material and Methods: 26 HIV-infected patients and 142 non-HIV-infected patients (control group) were included in this study. Panoramic radiographs of the participants were assessed considering mandibular cortical index (MCI). Non-parametric comparisons between groups were performed, using Mann-Whitney test, at a level significance level of p= 0.05. Results: HIV-infected patients presented lower bone mineral density (BMD) at mandible, assessed by MCI in panoramic radiographs when compared to non-HIV-infected patients. The medication intake of HIV-infected patients was highly heterogeneous and could not be associated to the low BMD presented in the mandibular cortex. Conclusions: HIV-infected patients may present lower mandibular BMD than non-HIV-infected patients. (AU)

Objetivo: O objetivo deste estudo foi avaliar as alterações osteoporóticas mandibulares em pacientes com infecção por HIV comparando-os com pacientes não infectados, por meio de radiografias panorâmicas. Material e Métodos: 26 pacientes infectados pelo HIV e 142 pacientes não infectados (grupo controle) foram incluídos neste estudo. As radiografias panorâmicas dos participantes foram avaliadas considerando o índice da cortical mandibular (MCI). Comparações não paramétricas entre os grupos foram realizadas, com o teste de Mann-Whitney e nível de significância de p = 0,05. Resultados: Pacientes infectados pelo HIV apresentaram menor densidade mineral óssea (BMD) na mandíbula, avaliada pelo MCI em radiografias panorâmicas, quando comparados aos pacientes não infectados pelo HIV. A ingestão de medicamentos de pacientes infectados pelo HIV foi altamente heterogênea e não pôde ser associada à baixa BMD apresentada no córtex mandibular. Conclusões: Pacientes infectados pelo HIV podem apresentar BMD mandibular menor do que pacientes não infectados pelo HIV. (AU)

Gardner syndrome imaging features in plain radiographs and computed tomography: a case report / Síndrome de Gardner: Características imaginológicas por meio da radiografia convencional e tomografia computedorizada

Gardner syndrome (GS) is a genetic disease with high penetration characterized by a signal triad of colonic polyposis, multiple osteomas and mesenchymal tumors in the soft tissues and skin. The colonic polyposis is associated to the development of malignant disease. Patients may also present maxillomandibular alterations such as impacted teeth, supernumerary teeth, congenital missing teeth and odontomas. Bone lesions and maxillomandibular alterations usually precedes the gastrointestinal alterations; hence dentists should be aware of GS syndrome main radiographic signals, in order to detect the disease and proper referred the patient to medical treatment and surveillance. Thus, in this report, it is described a case of GS in a male patient, as well as discussed GS features.(AU)

A síndrome de Gardner (GS) é uma doença genética caracterizada pela seguinte tríade: polipose colônica, múltiplos osteomas e tumores mesenquimais em tecidos moles e pele. A polipose colônica está associada ao desenvolvimento de tumores malignos. Os pacientes também podem apresentar alterações maxilomandibulares, como dentes impactados, dentes supranumerários, agenesia congênita e odontomas. Lesões ósseas e alterações maxilomandibulares geralmente precedem as alterações gastrointestinais; portanto, os dentistas devem estar cientes dos principais sinais imaginológicos da GS, a fim de detectar a doença e encaminhar adequadamente o paciente para tratamento. Neste relato de caso é descrito um caso de GS em um paciente do gênero masculino, além de discutir as características da GS.(AU)

Comparison between different cone-beam computed tomography devices in the detection of mechanically simulated peri-implant bone defects

Purpose@#This study compared 2 cone-beam computed tomography (CBCT) systems in the detection of mechanically simulated peri-implant buccal bone defects in dry human mandibles. @*Materials and Methods@#Twenty-four implants were placed in 7 dry human mandibles. Peri-implant bone defects were created in the buccal plates of 16 implants using spherical burs. All mandibles were scanned using 2 CBCT systems with their commonly used acquisition protocols: i-CAT Gendex CB-500 (Imaging Sciences, Hatfield, PA, USA; field of view [FOV], 8 cm×8 cm; voxel size, 0.125 mm; 120 kVp; 5 mA; 23 s) and Orthopantomograph OP300 (Intrumentarium, Tuusula, Finland; FOV, 6 cm×8 cm; voxel size, 0.085 mm; 90 kVp; 6.3 mA; 13 s). Two oral and maxillofacial radiologists assessed the CBCT images for the presence of a defect and measured the depth of the bone defects. Diagnostic performance was compared in terms of the area under the curve (AUC), accuracy, sensitivity, specificity, and intraclass correlation coefficient. @*Results@#High intraobserver and interobserver agreement was found (p<0.05). The OP300 showed slightly better diagnostic performance and higher detection rates than the CB-500 (AUC, 0.56±0.03), with a mean accuracy of 75.0%, sensitivity of 81.2%, and specificity of 62.5%. Higher contrast was observed with the CB-500, whereas the OP300 formed more artifacts. @*Conclusion@#Within the limitations of this study, the present results suggest that the choice of CBCT systems with their respective commonly used acquisition protocols does not significantly affect diagnostic performance in detecting and measuring buccal peri-implant bone loss.

Evaluation and Correlation between craniofacial bone densities and C1 and C2 cervical vertebrae using multislice computed tomography / Avaliação e Correlação entre as densidades ósseas craniofaciais e vértebras cervicais C1 e C2 por meio de tomografia computadorizada multislice

Objective: To evaluate the use of computed tomography (CT) as an osteoporosis screening tool, evaluating the relation between the bone mineral density (BMD) from maxilla and mandible with the cervical vertebrae, using the Hounsfield units (HU). Material and Methods: It was included in this study a convenience sample of 118 multislice CT examinations from patients who underwent maxilla, mandible and cervical vertebrae (C1 and C2) simultaneously scans. For each patient, the following regions on both sides of head CT scans were assessed in sagittal slice: above maxillary central and lateral incisors apexes; maxillary tuberosity; mandible head; mandible body endosteum; mandible body trabeculae and vertebrae C1 and C2. HU were measured in each area using a 0.5 cm region of interest (ROI) positioned in the center of the slice. Results: It was verified that there is a correlation between the BMD of the C1 and C2 vertebrae and the anterior region of the maxilla. It was not found correlation between the vertebrae, C1 and C2, and the other structures analyzed. Conclusions: This study showed that this method can be a good screening tool to diagnosis of osteoporosis, when evaluated the correlation between C1 and C2 vertebrae and anterior region of maxilla. More studies are necessary to evaluate the possibility of using CT as an osteoporosis screening tool. (AU)

Objetivos: Avaliar o uso da tomografia computadorizada como ferramenta de rastreamento da osteoporose, avaliando a relação entre a densidade mineral óssea da maxila e mandíbula com as vértebras cervicais, utilizando as unidades de Hounsfield. Material e métodos: Neste estudo foram incluidos uma amostra de 118 pacientes submetidos à exames de tomografia computadorizada multislice que apresentavam as estruturas anatomicas da maxila, mandibula e as vértebras cervicais (C1 e C2) simultaneamente. Para cada paciente, as seguintes regiões dos dois lados da tomografia computadorizada da cabeça foram avaliadas em corte sagital: acima dos ápices dos incisivos centrais e laterais superiores; tuberosidade maxilar; cabeça da mandíbula; endósteo do corpo da mandíbula; trabéculas do corpo da mandíbula e vértebras C1 e C2. As unidades de Hounsfield foram medidas em cada área usando uma região de interesse de 0,5 cm (ROI) posicionada no centro do corte. Resultados: Verificou-se uma correlação positiva entre a densidade mineral óssea das vértebras C1 e C2 e a região anterior da maxila. Não foram encontradas correlação entre as vértebras C1 e C2 e as demais estruturas analisadas. Conclusão: Este estudo mostrou que esse método pode ser uma ferramenta de triagem para o diagnóstico de osteoporose, quando avaliada a correlação entre as vértebras C1 e C2 e a região anterior da maxila. Mais estudos são necessários para avaliar a possibilidade do uso da tomografia computadorizada como ferramenta de rastreamento da osteoporose. (AU)

Does type 2 diabetic osteoporotic patients present more periodontal risks than non-osteoporotic patients? An evaluation with mandibular cortical index (Klemetti)

Aim: This study aim was to evaluate if patients with type 2 diabetes and osteoporosis have an increased risk of periodontal disease (horizontal and vertical bone loss) when compared to diabetic patients without osteoporosis. Additionally, to assess if patients with diabetes and osteoporosis have a greater risk of reduction of bone mineral density in the mandible, expressed by mandibular cortical index (MCI) when compared to diabetic patients without osteoporosis. Methods: 59 patients (39 diagnosed with type 2 diabetes and osteoporosis; 20 diagnosed with type 2 diabetes and without osteoporosis) were selected. Type 2 diabetes was previously diagnosed by glycated hemoglobin examination and osteoporosis by peripheral dual-energy x-ray absorptiometry. Mandibular cortical index, as well as the presence of vertical and horizontal bone loss was verified on panoramic radiographs. Adjusted odds ratio analyses were performed on presence of periodontal disease and MCI considering the effect of osteoporosis. Results: Absence of statistical significance between variables was found. Conclusions: There is no difference between the risk of periodontal disease or low MCI among osteoporotic and non-osteoporotic type 2 diabetic patients

Comparison of conventional imaging techniques and CBCT for periodontal evaluation: A systematic review

PURPOSE: This study aimed to carry out a systematic review of studies in the literature comparing conventional imaging techniques with cone-beam computed tomography in terms of the role of these techniques for assessing any of the following periodontal conditions and parameters: infrabony defects, furcation involvement, height of the alveolar bone crest, and the periodontal ligament space. MATERIALS AND METHODS: Interventional and observational studies comparing conventional imaging techniques with cone-beam computed tomography were considered eligible for inclusion. The MEDLINE and Embase databases were searched for articles published through 2017. The PRISMA statement was followed during data assessment and extraction. RESULTS: The search strategy yielded 351 publications. An initial screening of the publications was performed using abstracts and key words, and after the application of exclusion criteria, 13 studies were finally identified as eligible for review. CONCLUSION: These studies revealed cone-beam computed tomography to be the best imaging technique to assess infrabony defects, furcation lesions, the height of the alveolar bone crest, and the periodontal ligament space.

Bone mineral density and mandibular osteoporotic alterations in type 2 diabetes / Densidade mineral óssea e alterações osteoporóticas na mandíbula em pacientes diabéticos do tipo 2

Objective: To assess the influence of type 2 diabetes on bone mineral density in a group of type 2 diabetic patients, in comparison with non-diabetic patients. Additionally, to evaluate the correlation between mandibular cortical index and bone mineral density. Material and Methods: 48 patients (24 diabetics and 24 non-diabetics) referred for femur and spine densitometry and panoramic radiograph examination were included in this study. Patients were diagnosed based on densitometric results of the total femur and total spine. All panoramic radiomorphometric measurements were performed by 3 observers. Differences in T and Z-scores between both groups were evaluated with Mann-Whitney test and non-parametric correlations between mandibular cortical index and T/Z-scores were carried out with Spearman's test. Results: Median T and Z-scores for total femur and total spine presented no statistical significant difference between diabetic and nondiabetic patients. In addition, only diabetics total femur and non-diabetics total spine T-scores were significantly correlated with mandibular cortical index. Conclusion: The present results suggest that type 2 diabetic patients have similar Z and T-scores in femur and spine when compared to non-diabetic patients. Mandibular cortical index, assessed on panoramic radiographs is inversely correlated with femur densitometry results in diabetics and spine bone mineral density in nondiabetic patients. (AU)

Objetivo: avaliar a influência do diabetes tipo 2 na densidade mineral óssea em um grupo de pacientes diabéticos do tipo 2, em comparação com pacientes não diabéticos. Adicionalmente, analisar a correlação entre o índice cortical mandibular e a densidade mineral óssea. Material e Métodos: 48 pacientes (24 diabéticos e 24 não diabéticos) que realizaram densitometria óssea de fêmur e coluna vertebral e exame radiográfico panorâmico foram incluídos neste estudo. Os pacientes foram diagnosticados com base nos resultados densitométricos do fêmur total e da coluna total. Por meio das radiografias panorâmicas, 3 observadores avaliaram o índice da cortical mandibular. Diferenças em T e Z scores entre os dois grupos foram avaliadas com o teste de MannWhitney e as correlações não paramétricas entre o índice cortical mandibular e os scores da densitometria foram verificadas por meio do teste de Spearman. Resultados: A mediana dos T e Z-scores para fêmur total e coluna total não apresentaram diferença estatisticamente significante entre diabéticos e não-diabéticos. Além disso, houve correlação significativa com o índice da cortical mandibular somente os T-scores de fêmur total do grupo de pacientes diabéticos e de coluna total dos paciente não-diabéticos. Conclusão: Os resultados deste estudo sugerem que pacientes diabéticos tipo 2 tem densidade mineral óssea aferida por meio de densitometria óssea do fêmur e coluna total semelhantes aos não-diabéticos. O índice cortical mandibular, avaliado em radiografias panorâmicas, foi inversamente correlacionado com os resultados da densitometria do fêmur em pacientes diabéticos e da densitometria de coluna total de pacientes não diabéticos. (AU)

Lingual mandibular bone defect: imaging features in panoramic radiograph, multislice computed tomography and magnetic resonance imaging / Defeito ósseo submandibular: características de imagem em radiografia panorâmica, tomografia computadorizada multislice e ressonância magnética

Stafne bone defect or mandibular bone depression is defined as a bone developmental defect usually filled with soft or salivary gland tissue. Lingual posterior variant incidence is less than 0.5%. We reported a case of an 80 years old Asian female asymptomatic patient who underwent routine panoramic radiographic examination and a radiolucent area in mandible was noticed as an incidental finding, with initial provisional diagnosis of traumatic bone cyst, aneurysmal bone cyst and lingual mandibular bone defect. The patient was then referred to multislice computed tomography and magnetic resonance imaging. Computed tomography showed a hypodense area with discontinuity in mandible base. Magnetic resonance imaging demonstrated a hyperintense image eroding mandibular body in contact with submandibular gland, which corresponded to fatty tissue and due to these imaging findings, the final diagnosis was lingual mandibular bone defect. Although the defect is a benign lesion and interventional treatment is not necessary, radiolucencies in mandible should be detailed investigated, due to their radiographic features that can resemble to other intrabony lesions. Imaging examinations can provide great defect details, especially magnetic resonance imaging, which can allow the identification of glandular tissue continuity to the mandibular defect.(AU)

O defeito ósseo do Stafne ou o defeito ósseo da mandíbula é definido como uma cavidade óssea geralmente preenchida com tecido glandular salivar. A incidência de variante lingual posterior é inferior a 0,5%. Neste relato, foi descrito um caso de paciente de paciente de 80 anos, etnia asiática e assintomática que foi submetida a exames radiográficos panorâmicos de rotina no qual observou-se incidentalmente uma área radiolúcida na mandíbula. Os diagnósticos iniciais foram de: cisto ósseo traumático, cisto ósseo aneurismático e defeito ósseo mandibular. A paciente foi encaminhada para realização de tomografia computadorizada multislice e ressonância magnética. A tomografia computadorizada mostrou uma área hipodensa com descontinuidade na base da mandíbula. A ressonância magnética demonstrou uma imagem hiperintensa no corpo da mandíbula, em contato com a glândula submandibular, correspondendo a tecido adiposo. Devido a estes achados imaginológicos, o diagnóstico final foi de defeito ósseo mandibular. Embora este defeito seja uma lesão benigna sem necessidade de tratamento intervencionista, as radiolucências na mandíbula, por conta de sua semelhança com outras lesões intraósseas, devem ser devidamente investigadas. Os exames de imagem podem fornecer detalhes do defeito, especialmente imagens de ressonância magnética, que podem permitir a identificação da continuidade do tecido glandular ao defeito mandibular.(AU)

Parotid mandibular bone defect: A case report emphasizing imaging features in plain radiographs and magnetic resonance imaging

Mandibular bone depression, also known as Stafne bone cavity, is defined as a bone depression filled mainly with salivary gland tissue. Parotid gland bone defects are infrequently observed. We report the case of a 52-year-old male patient who underwent radiographic examinations due to temporomandibular joint dysfunction, and a radiolucent area was detected in the mandibular ramus, with a provisional diagnosis of traumatic bone cyst or parotid mandibular bone defect. The patient was then referred for magnetic resonance imaging, which demonstrated a hyperintense area eroding the mandibular ramus, which corresponded to glandular tissue. Although the defect was a benign lesion, radiolucencies in the mandibular ramus lead to concerns among professionals, because their radiographic features can resemble various intrabony neoplastic lesions, such as giant cell tumors or benign tumors of the parotid gland.

Fragile X syndrome: panoramic radiographic evaluation of dental anomalies, dental mineralization stage, and mandibular angle

ABSTRACT Fragile X syndrome (FXS) is a disorder linked to the chromosome X long arm (Xq27.3), which is identified by a constriction named fragile site. It determines various changes, such as behavioral or emotional problems, learning difficulties, and intellectual disabilities. Craniofacial abnormalities such as elongated and narrow face, prominent forehead, broad nose, large and prominent ear pavilions, strabismus, and myopia are frequent characteristics. Regarding the oral aspects, deep and high-arched palate, mandibular prognathism, and malocclusion are also observed. Objective: The purpose of this study was to evaluate the dental radiographic characteristics as described in 40 records of patients with panoramic radiography. Material and Methods: The patients were in the range of 6–17 years old, and were divided into two groups (20 subjects who were compatible with the normality standard and 20 individuals diagnosed with the FXS), which were matched for gender and age. Analysis of the panoramic radiographic examination involved the evaluation of dental mineralization stage, mandibular angle size, and presence of dental anomalies in both deciduous and permanent dentitions. Results: The results of radiographic evaluation demonstrated that the chronology of tooth eruption of all third and second lower molars is anticipated in individuals with FXS (p<0.05). In this group, supernumerary deciduous teeth (2.83%), giroversion of permanent teeth (2.31%), and partial anodontia (1.82%) were the most frequent dental anomalies. In addition, an increase was observed in the mandibular angle size in the FXS group (p<0.05). Conclusion: We conclude that knowledge of dental radiographic changes is of great importance for dental surgeons to plan the treatment of these individuals.

Diagnostic performance of fractal dimension and radiomorphometric indices from digital panoramic radiographs for screening low bone mineral density

A number of panoramic radiographic measurements have been associated with osteoporotic alterations. However, little is known about the differences in sensitivity and specificity among these measurements for screening low bone mineral density (BMD). Aim: To correlate and compare precision, sensitivity and specificity of panoramic radiomorphometric indices and fractal dimension (FD) for screening low BMD (i.e. osteopenia and osteoporosis). Methods: Sixty-eight female patients (42.78±15.59 years) were included in this study. Body mass index (BMI), mandibular cortical index (MCI), mandibular cortical width (MCW), FD and connectivity (C) were assessed. Low BMD was diagnosed by peripheral dual-energy X-ray absorptiometry (p-DXA). Non-parametric correlations were assessed among all variables. In addition, sensitivity and specificity of MCI, MCW and FD were estimated for screening low BMD. Results: Significant correlation was found between FD and BMI (p=0.013; r=0.269). In addition, FD was the most sensitive method for screening low BMD (70.8%, p=0.001). FD and MCI presented a significant and relatively high sensitivity, whereas MCW presented a high specificity for screening low systemic BMD Conclusions: Among the analyzed methods, FD and MCI offer a significant and relatively high sensitivity, whereas MCW offers a high specificity for screening low BMD (Au)

Comparison of the diagnostic performance of panoramic and occlusal radiographs in detecting submandibular sialoliths

PURPOSE: The aim of this study was to assess and compare the diagnostic performance of panoramic and occlusal radiographs in detecting submandibular sialoliths. MATERIALS AND METHODS: A total of 40 patients (20 cases and 20 controls) were included in this retrospective study. Cases were defined as subjects with a submandibular sialolith confirmed by computed tomography (CT), whereas controls did not have any submandibular calcifications. Three observers with different expertise levels assessed panoramic and occlusal radiographs of all subjects for the presence of sialoliths. Intraobserver and interobserver agreement were assessed using the kappa test. Sensitivity, specificity, accuracy, positive and negative predictive values, and the diagnostic odds ratio of panoramic and occlusal radiographs in screening for submandibular sialoliths were calculated for each observer. RESULTS: The sensitivity and specificity values for occlusal and panoramic radiographs all ranged from 80% to 100%. The lowest values of sensitivity and specificity observed among the observers were 82.6% and 80%, respectively (P=0.001). Intraobserver and interobserver agreement were higher for occlusal radiographs than for panoramic radiographs, although panoramic radiographs demonstrated a higher overall accuracy. CONCLUSION: Both panoramic and occlusal radiographic techniques displayed satisfactory diagnostic performance and should be considered before using a CT scan to detect submandibular sialoliths.

Comparación de dos métodos radiológicos para evaluación de densidad ósea en mujeres posmenopáusica / Comparison of two radiological methods for evaluation of bone density in postmenopausal women

Debido a la importancia del diagnóstico precoz de osteoporosis, fue objeto de este estudio realizar la comparación de dos métodos radiológicos convencionales para la evaluación de la densidad ósea en mujeres posmenopáusicas. Fueron seleccionadas imágenes de radiografía panorámica y de radiografía carpal, correspondiente a 68 pacientes de sexo femenino, con edades comprendidas entre los 49 y 80 años de edad, realizadas en la Clínica de Radiología Odontológica, para evaluación previa a la colocación de implantes. Para la interpretación de la densidad ósea en la mandíbula a través de las radiografías panorámicas fue utilizado el método del espesor cortical mandibular (PMI). Para la evaluación de las imágenes radiológicas obtenidas por la radiografía carpal, fue aplicado el método de la radiogrametría. Se concluye que existe correlación entre la presencia de una baja densidad ósea a nivel mandibular observada en la radiografía panorámica en las pacientes de la muestra, con la baja densidad ósea presentada en la radiografía carpal.

Due the importance of diagnosis precocious of osteoporosis, this study carried out the comparison of two conventional radiological methods for the evaluation of bone density in postmenopausal women. X-ray images of panoramic and carpal were selected, corresponding to 68 women between 49 and 80 years old, obtained at the Clinic of Dental Radiology, for holding dental implant. The interpretation of bone density in jaw on panoramic radiography was the method to determine mandibular cortical thickness. The carpal radiography was evaluated for the radiogrammetry method. It was concluded that there was a correlation between low bone density observed in the mandibular panoramic radiography with low bone density on carpal radiography.

Effectiveness of ultrasonography in detecting intraosseous vascularization: an in-vitro study

A ultrassonografia é um recurso de imagem para a finalidade de diagnosticar lesões e para avaliar o grau de vascularização intraóssea de tumores. No entanto, lesões intraósseas podem representar um desafi o devido à espessura de osso circundante que poderá impedir a captura do sinal de ultrassom. O objetivo deste estudo foi avaliar a infl uência da espessura óssea na captura do sinal de eco dos vasos utilizando a ultrassonografi a. Hemimandíbulas maceradas suínas (n = 20) com espessuras ósseas diferentes foram adaptadas para receber tubos de borracha tipo CFlex ligados a um capilar de vidro, por onde água foi conduzida por meio de uma bomba para simular a vascularização sanguínea. A ultrassonografi a Doppler foi usada para avaliar o fl uxo de sangue na região do canal mandibular ao nível dos dentes molares. O teste t de Student foi utilizado para avaliar as diferenças entre as espessuras de osso das hemimandíbulas por meio de sinal negativo e sinal positivo do ultrassom. A reprodutibilidade e a confi abilidade foram confi rmadas para as análises. O sinal de fl uxo simulado foi capturado em ossos corticais com espessura na faixa de 0,2 a 1,0 mm (0.59 0.42 mm), mas não foi capturado a uma espessura superior a 1,0 mm (1.39 0.59 mm). Concluindo, a ultrassonografi a pode ser usada para investigar a vascularização intraóssea em áreas mandibulares com uma espessura óssea vestibular de até 1,0 mm.

Ultrasonography is useful to diagnose lesions, insofar as it detects the type of injury, and to assess the degree of vascularization of tumors. However, intraosseous lesions may represent a challenge, since the surrounding bone thickness could prevent ultrasound signal capture. The aim of this study was to evaluate the infl uence of surrounding bone thickness on the ability of ultrasonography in capturing the echo signal of blood vessels. Macerated porcine hemimandibles (n = 20) with different buccal bone thicknesses were prepared and adapted to receive CFlex-type rubber tubes connected to a glass capillary through which pump-driven water was conducted to simulate blood vasculature. Doppler ultrasonography was used to assess the blood fl ow in the region of the mandibular canal at the level of the molar teeth. Student’s t-test was used to assess differences between the bone thicknesses of hemimandibles with a negative and with a positive ultrasound signal. The presence of the echo signal in the simulated vasculature was assessed by ultrasonography. Reproducibility and reliability were confi rmed for the analyses. The simulated fl ow signal was captured in cortical bones with a thickness in the 0.2–1.0 mm range (0.59 ± 0.42 mm), but was not captured in those with a thickness greater than 1.0 mm (1.39 ± 0.59 mm). In conclusion, ultrasonography can be used to investigate intraosseous vascularization in mandibular areas with a buccal bone thickness up to 1.0 mm.

Evaluation of basilar expansion and internal septa of human sphenoidal sinus using cone beam computed tomography

O objetivo deste estudo foi avaliar os tipos e as frequências de expansão basilar do seio esfenoidal e septos internos utilizando tomografi a computadorizada de feixe cônico. Imagens arquivadas de 300 indivíduos adultos de ambos os gêneros foram recuperadas. Foi realizada uma análise descritiva relacionando idade e gênero à expansão basilar do seio esfenoidal e a tipos de septos internos e frequências. As associações entre expansão basilar do seio esfenoidal, septos internos e gênero para cada grupo de idade foram avaliadas por meio do teste do qui-quadrado ou teste exato de Fisher. Entre todas as imagens avaliadas, 69% apresentaram expansão basilar do seio esfenoidal, das quais 81% foram consideradas críticas. Septos internos foram observados em 60% das imagens. Não houve relação entre presença de expansão basilar do seio esfenoidal, gênero e idade. Septos internos apresentaram-se independentes do gênero; no entanto, dentre os indivíduos com mais de 40 anos de idade, 36% tinham apenas um septo principal, 6% tinham septos acessórios, e 18% tinham ambos os tipos de septos. A tomografia computadorizada é um método preciso que deve ser considerado para a avaliação desse segmento anatômico a fi m de evitar a exposição desnecessária à radiação.

The objective of this study was to assess the types and frequencies of basilar expansion of the sphenoidal sinus and internal septa by using cone beam computed tomography. Archived images from 300 adult subjects of both genders were retrieved. A descriptive analysis relating age and gender to basilar expansion of the sphenoidal sinus and internal septa types and frequencies was performed. The associations between basilar expansion of the sphenoidal sinus, internal septa and gender for each age group were assessed using the chi-square test or Fisher’s exact test. Among all the images evaluated, 69% showed basilar expansion of the sphenoidal sinus, of which 81% were considered critical. Internal septa were observed in 60% of the images. There was no relationship between the presence of basilar expansion of the sphenoidal sinus and gender and age. Internal septa were independent of gender; however, of the subjects older than age 40, 36% had only a main septum, 6% had accessory septa, and 18% had both types of septa. Cone beam computed tomography is an accurate method that should be considered for the evaluation of this anatomic segment in order to avoid unnecessary exposure to radiation.

Comparative spectrophotometric study of the color stability of three dental porcelains after repeated fi rings

O objetivo deste estudo foi avaliar a estabilidade de cor de três marcas comerciais de porcelanas dentais aluminizadas durante seu processo de queima. Essas porcelanas são utilizadas para a confecção de dentes de prótese fi xa. Para o experimento foram confeccionados 30 corpos-de-prova em forma de disco com 2 mm de espessura e 10 mm de circunferência, sendo 10 da marca AllCeram, 10 da marca Noritake Cerabien CZR e 10 da marca Vita VM7. As amostras foram queimadas 10 vezes. As leituras de cor foram feitas em espectrofotômetro de refl exão nos seguintes intervalos: após a 1a queima, após a 3 queima, após a 5a queima e após a 10a queima. As curvas de refl exão foram convertidas em valores LAB e a diferença de cor foi medida por meio do método CIELAB (E). Os resultados obtidos demonstraram que existe variação de cor e que essa variação depende do número de queimas realizadas e da marca comercial utilizada.

The purpose of this investigation was to quantify the color differences in CIE ΔE units produced by multiple fi rings of three all-ceramic systems used in the fabrication of prosthodontic teeth. Thirty samples of the following brands were fabricated: AllCeram, Noritake Cerabien CZR and Vita VM7. A spectrophotometer was used for refl ectance measurement of color after 1 fi ring, 3 fi rings, 5 fi rings and 10 fi rings. The results were converted into CIELAB units. Color differences (ΔE) were calculated in the CIE color space. The color differences resulting from multiple fi rings proved to be dependent on the number of fi rings and on the porcelain brand tested.

An alternative approach to extruding a vertically impacted lower third molar using an orthodontic miniscrew: A case report with cone-beam CT follow-up

One of the most common oral surgical procedures is the extraction of the lower third molar (LTM). Postoperative complications such as paresthesia due to inferior alveolar nerve (IAN) injury are commonly observed in cases of horizontal and vertical impaction. The present report discusses a case of a vertically impacted LTM associated with a dentigerous cyst. An intimate contact between the LTM roots and the mandibular canal was observed on a panoramic radiograph and confirmed with cone-beam computed tomographic (CBCT) cross-sectional cuts. An orthodontic miniscrew was then used to extrude the LTM prior to its surgical removal in order to avoid the risk of inferior alveolar nerve injury. CBCT imaging follow-up confirmed the success of the LTM orthodontic extrusion.

Evaluation of linear tomography and cone beam computed tomography accuracy in measuring ridge bone width for planning implant placement

The development of oral implantology has led to the establishment of various image-acquisitionmethods as important surgical diagnosis tools, such as linear (LT) and cone beam computedtomography (CBCT), indicated for planning implant placement surgeries. However, there still islittle information in the literature regarding details on the difference between the accuracy of thesemethods. Aim: The aim of the present study was to assess the difference between the accuracyof LT and CBCT in measuring ridge bone width. Methods: A sample of ten human skulls wasused, totaling 40 edentulous sites, marked with 2-mm gutta-percha balls in the buccal and lingualplates. Buccal-lingual measurements of ridge width were performed on the images of bothtomography types. Direct caliper measurements were used as control values, to which all LT andCBCT measurements were compared. Results: CBCT images showed significantly more accurateresults in comparison with the direct caliper measurements (p<0.05). Conclusions: CBCTproved more reliable than LT regarding ridge bone measurements for dental implant planning.